RecruitingNot ApplicableNCT06387095

Efficacy of Parasternal Blocks in Cardiovascular Surgery Patients Undergoing Median Sternotomy

Efficacy of Parasternal Blocks in Cardiovascular Surgery Patients Undergoing Median Sternotomy: Randomized, Controlled Study

Sponsor

Kartal Kosuyolu Yuksek Ihtisas Education and Research Hospital

Enrollment

300 participants

Start Date

Feb 1, 2024

Study Type

INTERVENTIONAL

Conditions

Postoperative Pain

Summary

Acute and chronic pain after cardiac surgery is a common problem that negatively affects quality of life. Postoperative pain after cardiac surgery is most intense in the first two days and decreases in the following period. However, postoperative pain with incomplete management in the acute period may become chronic. This may negatively affect the patient's quality of life. Although central blocks such as thoracic epidural and paravertebral blocks are considered the gold standard in analgesia control, the advantages of thoracic plan blocks, which are more superficial due to peroperative heparinisation; coagulation disorders; and procedural difficulties, are undeniable. Thoracic plane blocks, which can also be used in patients receiving anticoagulant and/or antiplatelet therapy, have recently been used for acute pain. The aim of this study was to evaluate the effect of thoracic plane blocks on extubation time, pain scores, intensive care unit (ICU) and hospital stays in patients undergoing median sternotomy.

Eligibility

Min Age: 18 YearsMax Age: 80 Years

Inclusion Criteria4

Performing median sternotomy
Elective case
Over 18 years of age; under 80 years of age
ASA II-III patients

Exclusion Criteria7

Emergency cases
Patients undergoing minimally invasive surgery
Patients with a history of opioid use in the last 30 days
Redo cases
Patients with left ventricular ejection fraction less than 30%
Patients with severe hepatic or renal insufficiency
Patients with chronic pain before surgery (migraine, fibromyalgia)

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Interventions

PROCEDURE1. no block

After extubation, patient-controlled analgesia will be applied for 24 hours (with PCA infusion pump device). During the follow-up of the patients in intensive care, extubation times, additional analgesic needs, pain scores; intensive care and hospital discharge times will be recorded.

PROCEDURE2. superficial parasternal block

After induction, the patient will undergo an ultrasound-guided superficial parasternal plan block. . After extubation, patient-controlled analgesia will be applied for 24 hours (with PCA infusion pump device). During the follow-up of the patients in intensive care, extubation times, additional analgesic needs, pain scores; intensive care and hospital discharge times will be recorded.

PROCEDURE3. deep parasternal block

After induction, the patient will undergo an ultrasound-guided deep parasternal plane block. . After extubation, patient-controlled analgesia will be applied for 24 hours (with PCA infusion pump device). During the follow-up of the patients in intensive care, extubation times, additional analgesic needs, pain scores; intensive care and hospital discharge times will be recorded.